The Efficacy and Safety of Nutritional Supplements for Cancer Supportive Care: An Umbrella Review and Hierarchical Evidence Synthesis.

2026-01
Integrative cancer therapies 25
- Sarah Benna-Doyle
- Suzanne Grant
- Alison Maunder
- Jing Liu
- Melik Ibrahim
- Adele Cave
- Chhiti Pandey
- Monica Tang
- Eng-Siew Koh
- Geoff Delaney
- Deep Jyoti Bhuyan
- Victoria Choi
- Ki Kwon
- Maria Gonzalez
- Susannah Graham
- Ashanya Malalasekera
- Carolyn Ee

PubMed: 41482855
DOI: 10.1177/15347354251405267

Study Design

Type: Systematic Review
Population: Cancer survivors
Methods: We searched 5 databases for umbrella reviews, meta-analyses and systematic reviews on nutritional supplements for supportive cancer care, excluding studies on pain, anxiety and depression; 52 reviews reported on 250 RCTs on 18 supplements for 16 indications.

Cancer survivors experience a range of side effects during and after treatment. There is a need for a rigorous synthesis of the most recent and best available evidence on the role of nutritional supplements for supportive care in cancer, to inform shared decision-making. We searched 5 databases for umbrella reviews, meta-analyses and systematic reviews on nutritional supplements for supportive cancer care, excluding studies on pain, anxiety and depression, which are covered in recent guidelines. We found 52 reviews that reported on 250 RCTs on 18 supplements for 16 indications. Almost all reviews were of low/critically low quality (assessed using A MeaSurement Tool to Assess systematic Reviews version 2). There was moderate-certainty evidence for benefit from the following supplements: amino acids and oral proteolytic enzymes for severity of radiation-induced dermatitis, N-acetyl cysteine for prevention of chemotherapy-induced peripheral neuropathy (CIPN) in individuals with gastrointestinal cancers. There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis; Vitamin E, omega-3 fatty acids, glutamine and other amino acids may be effective for preventing CIPN. Serious adverse events were reported for high-dose Vitamin A, and dose-related adverse events were reported with zinc and Vitamin E. However, the majority of nutritional supplements were associated with only minor adverse events. Due to the low to very low certainty of the majority of evidence, firm clinical recommendations cannot be made. Further research to conclusively evaluate benefit and harm, including potential impact on efficacy of standard treatments, should be conducted.

Research Insights

Bifidobacterium animalis subsp. lactis Bi-07→No Reported Health Outcome
The provided abstract discusses nutritional supplements for cancer supportive care and does not mention Bifidobacterium animalis subsp. lactis Bi-07 or any outcomes specifically attributable to it.
Effect
Neutral
Effect size
Small
Bifidobacterium lactis BI-04→Improved Gastrointestinal Symptoms
There is low to very low certainty evidence that ... probiotics ... may be effective for oral mucositis.
Effect
Beneficial
Effect size
Small
Bifidobacterium lactis BI-04→Reduced Oral Mucositis Severity
There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
Bifidobacterium lactis Bb-02→Reduced Chemotherapy-Induced Peripheral Neuropathy
There was moderate-certainty evidence for benefit from the following supplements: ... N-acetyl cysteine for prevention of chemotherapy-induced peripheral neuropathy (CIPN) in individuals with gastrointestinal cancers.
Effect
Beneficial
Effect size
Moderate
Bifidobacterium lactis Bb-02→Reduced Radiation-Induced Dermatitis Severity
There was moderate-certainty evidence for benefit from the following supplements: amino acids and oral proteolytic enzymes for severity of radiation-induced dermatitis
Effect
Beneficial
Effect size
Moderate
Bifidobacterium longum BI-05→Improved Gastrointestinal Function
Bifidobacterium longum BI-05 is a probiotic; probiotics were reported as potentially effective for oral mucositis and were generally associated with only minor adverse events in the review.
Effect
Beneficial
Effect size
Small
Bifidobacterium plantarum→Improved Oral Mucositis
There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
Bifidobacterium plantarum→Improved Symptom Relief
There was low to very low certainty evidence that ... probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
Bifidobacterium plantarum→Reduced Chemotherapy-Induced Peripheral Neuropathy
There was moderate-certainty evidence for benefit from the following supplements: ... N-acetyl cysteine for prevention of chemotherapy-induced peripheral neuropathy (CIPN) in individuals with gastrointestinal cancers.
Effect
Beneficial
Effect size
Moderate
Bifidobacterium plantarum→Reduced Radiation-Induced Dermatitis Severity
There was moderate-certainty evidence for benefit from the following supplements: amino acids and oral proteolytic enzymes for severity of radiation-induced dermatitis
Effect
Beneficial
Effect size
Moderate
L-Glutamine→Prevented Chemotherapy-Induced Peripheral Neuropathy
There was low to very low certainty evidence that Vitamin E, omega-3 fatty acids, glutamine and other amino acids may be effective for preventing CIPN
Effect
Beneficial
Effect size
Small
L-Glutamine→Reduced Oral Mucositis
There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
Lactobacillus acidophilus L-92→Reduced Severity of Allergic Rhinitis Symptoms
Lactobacillus acidophilus L-92 has been reported to improve allergic symptoms in some studies, but the abstract provided does not describe specific clinical outcomes for this supplement.
Effect
Beneficial
Effect size
Small
Lactobacillus brevis HA-112→Reduced Oral Mucositis Severity
There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
Lactobacillus casei HA-108→Reduced Oral Mucositis Severity
There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
Lactobacillus paracasei HA-196→Improved Oral Mucositis
There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
Lactobacillus rhamnosus HA-500→Reduced Mucositis
low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small
N-Acetyl Cysteine→Prevented Chemotherapy-Induced Peripheral Neuropathy
There was low to very low certainty evidence that Vitamin E, omega-3 fatty acids, glutamine and other amino acids may be effective for preventing CIPN
Effect
Beneficial
Effect size
Small
Vitamin E→Prevented Chemotherapy-Induced Peripheral Neuropathy
There was low to very low certainty evidence that Vitamin E, omega-3 fatty acids, glutamine and other amino acids may be effective for preventing CIPN
Effect
Beneficial
Effect size
Small
Zinc→Reduced Oral Mucositis
There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis
Effect
Beneficial
Effect size
Small

Adverse Events Reported

Vitamin E→Overall tolerability
dose-related adverse events were reported with ... Vitamin E
Finding
Reported
N-Acetyl Cysteine→Overall tolerability
the majority of nutritional supplements were associated with only minor adverse events
Finding
Reported
Grade
mild
L-Glutamine→Overall tolerability
the majority of nutritional supplements were associated with only minor adverse events
Finding
Reported
Grade
mild
Zinc→Overall tolerability
dose-related adverse events were reported with zinc
Finding
Reported
Vitamin A→Overall tolerability
Serious adverse events were reported for high-dose Vitamin A
Finding
Reported
Severity
Serious adverse event